President Obama today completed the first stage of his health reform initiative by signing H.R. 4872, the companion to the bill that created Patient Protection and Affordable Care Act.

Congress has been referring to H.R. 4872 as the Reconciliation Act of 2010, but the full name of the act will be the Health Care and Education Reconciliation Act of 2010.

HCERA includes college student aid provisions and a number of provisions that modify PPACA.

HCERA will increase the penalty for affected individuals who fail to buy the minimum required level of health coverage to $2,000, from $750; increase the penalty tax for affected employers that fail to provide the minimum level of health coverage to $2,000, from $750; ease the effects of a proposed 40% “Cadillac plan excise tax” on issuers of expensive health insurance plans; and impose a new tax on income from annuities and other investment vehicles.

The bill also includes Medicare and Medicaid provisions, a funding increase for community health centers, and a section that applies some PPACA consumer protection provisions, such as a ban on health coverage rescissions, even to existing health insurance plans that are “grandfathered in.”

America’s Health Insurance Plans, Washington, says policymakers should come together with health insurers to come up with better efforts to hold down health care spending.

“Ensuring that all Americans have access to coverage is a significant step forward for our country, but these reforms will only be sustainable if they are paired with real efforts to control costs,” AHIP President Karen Ignagni says in a statement.

The Centers for Medicare and Medicaid Services, the arm of the U.S. Department of Health and Human Services that will be responsible for implementing much of PPACA and HCERA, has been trying to prepare for the possibility of H.R. 3590 and H.R. 4872 becoming law, but it does not even have a permanent administrator, according to Jessica Waltman, a senior vice president at the National Association of Health Underwriters, Arlington, Va.

The health benefits continuation section of the Consolidated Omnibus Budget Reconciliation Act of 1986 is a far shorter, simpler piece of legislation that was signed into law long ago, but the final regulations for that legislation were not approved until 2004, Waltman says.

“It’s one thing for Congress to pass legislation,” Waltman says. “It’s another thing for people to implement it.”

***

Confused About PPACA And HCERA?

See: H.R. 3590 And H.R. 4872: A National Underwriter Guide To A New Health Reform World